913 (2) 619" 1 TtIL-'`COURT
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLIC TION FOR BUILDING PEIT
Date 19ZZ Perm
Application is herebmade for er it to'L* /(X7
a k story, Type _ uilding Use Zone
ParrOccupancy
to be occupied only as king Space
in accordance with Plans, Specifications and Plof-"t filed herewith, Fire S7-1. �
� /�j E�merrEec+�_Q
Estimated Value of Improvements, $ / - vs/� ✓
I certify that in the performance of the worirfor which this permit is issued I shall not employ any person
in any manner so as to violate the workman's compensation laws of California.
Ow rs o Address
By s�:: Address
RECORD OF INSPECTION
Foundation Frame
Stucco Sry Finish 7 SiA1/f�
CLAYBOURNE J_' 260-60IN
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